Medicine: Typhoid Carriers

Typhoid Carrier

Pennsylvania suffered in two spots last week from too much faith in scientific preventive medicine. The trouble began 40 years ago when Sir Almroth Edward Wright, redoubtable young Irishman, made inoculation against typhoid fever a practicable medical procedure. U. S. sani-tarians were slow to pick up his methods. Consequently 20,738 U. S. soldiers, nearly one-fifth of those mobilized, suffered from typhoid—1,580 died— during the brief War with Spain. Simultaneously Dr. Wright, as a member of the India Plague Commission, was inoculating 3,000 soldiers in India. Later he had every one of the 100,000 British soldiers who fought in the Boer War (1902) inoculated. Immediately thereafter (1902-07) he set up the system of therapeutic inoculations (vaccinotherapy) which can usually render bacterial infections harmless to man. One of its beneficial results occurred during the World War when of 2,000,000 U. S. soldiers inoculated before they sailed to fight in France only 488 contracted typhoid, only 88 died of the disease.

Sir Almroth’s wholesale prevention of disease contained an inherent danger to humanity which old Dr. Robert Koch, who discovered that germs actually cause disease and therefore that the destruction of germs would prevent disease, was quick to see. As far back as 1903, Koch warned doctors to beware typhoid carriers who show no signs of the disease, but carry in their gall bladders or intestines the germs with which others may be infected. Inoculation of such a carrier is wholly ineffective in destroying the typhoid bacillus which makes him a menace to society.

Women outnumber men 4-to-1 as carriers, most of whom prefer to become cooks. Many a U. S. community forbids known carriers of typhoid to handle food. Recalcitrant ones, like notorious “Typhoid Mary” Mallon of Manhattan, are forced into isolation.

One of this sad band of involuntary evildoers, Mrs. Fulmer App of Muncy, Pa. last March prepared and served pudding and salad to 70 guests at an old woman’s birthday party. Three guests died of typhoid fever, a dozen others were laid low, and last week Mrs. App, who knew what a menace she was and had been told to stay away from kitchens, was fined $50.

At Philadelphia last Decoration Day, 400 American Legionaries, their wives and children held a grand picnic. Twenty of the women pitched in to serve luncheon. Of the picnickers 66 contracted typhoid fever. Last week the fifth victim died. And last week examination by Philadelphia Health Department bacteriologists of the stools of the 20 women who had served so helpfully at the picnic demonstrated that two of them were carriers of typhoid fever. Because they were not among Philadelphia’s 30 labeled carriers and did not endanger the lives of relatives and friends out of wanton carelessness, names of the tainted pair were kept secret.